脊髓型颈椎病患者脊髓MRI T2WI高信号的危险因素

Risk factors of spinal cord increased signal intensity on T2-weighted magnetic resonance imaging in patients with cervical spondylotic myelopathy

中文关键词:  脊髓型颈椎病  MRI  高信号

英文关键词:Cervical spondylotic myelopathy  Magnetic resonance imaging  Increased signal intensity  Risk factor

中文摘要:

  【摘要】 目的：探讨脊髓型颈椎病（CSM）患者脊髓MRI T2WI高信号的危险因素。方法：2014年1月~2014年4月因CSM于我院骨科行手术治疗的185例患者被纳入研究。将脊髓MRI T2WI高信号分为3级：0级，无高信号；1级，T2WI有模糊而边界不清的高信号，且高信号范围局限于一个节段；2级，T2WI有明亮而边界清晰的高信号或高信号范围超过一个节段。在MRI T2WI横断位上测量脊髓压迫程度，在过伸、过屈位X线片上测量颈椎节段和整体活动度。对可能影响高信号的因素（性别、年龄、病程、术前mJOA评分、脊髓压迫程度、颈椎活动度、椎间盘退变程度）行单因素分析，挑选出有意义指标（P＜0.1）行有序Logistic回归分析。结果：脊髓MRI T2WI高信号的发生率为72.4%。按照分级标准，0级51例（27.6%），1级86例（46.5%），2级48例（25.9%）。性别和脊髓压迫程度对高信号的影响有统计学意义（女性相对于男性的OR=0.366，脊髓压迫比值的OR=0.904，P＜0.05），而年龄、病程、术前mJOA评分、椎间盘退变程度、颈椎活动度与高信号均无明显相关性（P＞0.05）。结论：男性、脊髓压迫程度重为CSM患者脊髓MRI T2WI高信号的独立危险因素。

英文摘要:

  【Abstract】 Objectives: To investigate the risk factors affecting the spinal cord increased signal intensity(ISI) on T2-weighted magnetic resonance imaging(MRI) in patients with cervical spondylotic myelopathy(CSM). Methods: From January 2014 to April 2014, 185 patients with CSM in Peking University Third Hospital receiving surgery were included in this study. ISI were classified in three grades: grade 0, no ISI; grade 1, faint and fuzzy border, located in one disc level; grade 2, intense and well-defined border, extending more than one disc level. The degree of spinal compression was measured on the T2-weighted transverse MRI, both segmental and total range of motion(ROM) of cervical spine were measured on the flexion-extension X-Ray. The factors that might affect the progression of ISI were analyzed by single factor analysis first: gender, age, duration of symptoms, preoperative mJOA score, degree of spinal compression, degree of intervertebral disc degeneration, ROM of cervical spine. Then the meaningful factors(P＜0.1) were picked out for ordinal Logistic regression analysis. Results: The incidence of ISI on T2-weighted MRI was 72.4%. According to the grading system: 51 cases in grade 0, accounting for 27.6%; 86 cases in grade 1, accounting for 46.5%; 48 cases in grade 2, accounting for 25.9%. The influence of gender and degree of spinal compression on ISI was statistically significant(female to male′s OR=0.366 and compression ratio′s OR=0.904, respectively, P＜0.05), while there was no significant correlation among age, duration of symptoms, preoperative mJOA score, degree of intervertebral disc degeneration, ROM of cervical spine and ISI(P＞0.05). Conclusions: Male and severe spinal compression were independent risk factors of spinal cord ISI on T2-weighted MRI in patients with CSM.